Andrea Guadalupe Perez Portillo, is a
Social Worker - Clinical based in Hercules, California. Andrea Guadalupe Perez Portillo is licensed to practice in California (license number 96134) and her current practice location is
1375 Sycamore Ave Apt 211, Hercules, California. She can be reached at her office (for appointments etc.) via phone at
(510) 253-5199.
NPI number for Andrea Guadalupe Perez Portillo is 1639624489 and her current mailing address is 1375 Sycamore Ave Apt 211, Hercules, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1639624489.
Healthcare Provider's Profile
Full Name | Andrea Guadalupe Perez Portillo |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1375 Sycamore Ave Apt 211, Hercules, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1639624489
- Provider Enumeration Date: 08/22/2016
- Last Update Date: 02/20/2024
Medical Identifiers
Medical identifiers for Andrea Guadalupe Perez Portillo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639624489 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 74204 (California) | Secondary |
104100000X | Social Worker | 74204 (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 74204 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 96134 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrea Guadalupe Perez Portillo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Andrea Guadalupe Perez Portillo, 1375 Sycamore Ave Apt 211, Hercules, CA 94547-5519 Ph: (510) 253-5199 | Andrea Guadalupe Perez Portillo, 1375 Sycamore Ave Apt 211, Hercules, CA 94547-5519 Ph: (510) 253-5199 |
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